Development and content validity of the youth and young-adult participation and environment measure (Y-PEM)

PURPOSE

To develop and evaluate the content of a self-reported measure of participation and environment, named Youth, Young-adult Participation and Environment Measure (Y-PEM), capturing participation at home, school, community, and the workplace among individuals with physical disabilities aged 12-30.

MATERIALS AND METHODS

A multi-phase sequential design based on elements of COnsensus for Standard Measurements INstrument was employed. Five consecutive rounds of cognitive interviews with 24 participants aged 12-33 years (X̅ = 20.9; n = 19 with a physical disability) and consultation with experts (n = 15) were conducted for item development and validation. Relevancy and clarity of items in each setting were assessed using the 10-cm Visual Analogue Scales (VASs).

RESULTS

Participants recommended adding activities specific to this age group (i.e., dating, caregiving, preparing meals, employment). On a 4-point Likert scale, work-related items were perceived important by experts (X̅ = 3.4) and young adults (X̅ = 3.1) with average clarity of 8.8 and relevancy of 8.4 out of 10, on the VASs. Similarly, the average clarity of items across settings (home, school, community) ranged from 6.9 to 8.7 and relevancy from 7.4 to 8.1. No modifications were required in environmental items.

CONCLUSIONS

Results suggest that Y-PEM is clear, relevant, comprehensive, and can be completed by individuals aged 12-30 with physical disabilities.IMPLICATIONS FOR REHABILITATIONThe Y-PEM can provide a standardized and systematic method to assess the first-hand subjective experience of youth and young adults with disabilities aged 12-30 in their participation at home, school, community, and the workplace.The Y-PEM can provide information regarding participation in activities that prepare youth or young adults for the job market as well as their perspective on the environmental barriers or supports that they may face in their employment.Clinicians can use the Y-PEM to identify environmental barriers and facilitators that impact participation across different settings and address them to further promote participation in meaningful and age-related activities.

Is the Y-PEM useful for me? Perspectives of youth with visual impairment

PURPOSE

To explore how youth with visual impairments perceive the usefulness of the Y-PEM (Youth and Young-adult Participation and Environment Measure) in capturing their participation and how information generated contributes to their understanding of participation experiences.

MATERIALS AND METHODS

A qualitative descriptive design was employed among 11 youth with visual impairment (3 females, 8 males) aged 17-24 (x¯ = 21, SD = 2.6) involving two remote sessions one week apart. First, the Y-PEM and QQ-10 questionnaire were administered to evaluate Y-PEM's utility (value and burden), analyzed descriptively. Then, youth reflected on their Y-PEM results via an individual semi-structured Stimulated Recall Interview (SRI), analyzed thematically.

RESULTS

A mean value-score of 77% (SD = 10.4) and burden-score of 19% (SD = 5.6) on the QQ-10 indicated the Y-PEM was perceived as valuable with relatively low burden. Three themes emerged from the interviews. Insights on participation revealed increased awareness of participation patterns and environmental factors. This led to a reflection on personal attributes about levels of comfort and familiarity, efforts required to participate, and personal preferences influencing participation experiences. Finally, approaches to participation elucidated strategies used in decision-making processes about pursuing participation.

CONCLUSION

Findings suggest the Y-PEM is useful in capturing and promoting reflection of youth's participation patterns and environmental supports/barriers.

Reliability and Validity of the Youth and Young-Adult Participation and Environment Measure (Y-PEM): An Initial Evaluation

AIM

To examine psychometric properties and aspects of utility of the Youth and young-adult Participation and Environment Measure (Y-PEM).

METHODS

Young people with and without physical disabilities (n = 113) aged 12 to 31 (x¯ = 23; SD = 4.3) completed an online survey containing the Y-PEM and QQ-10 questionnaire. To examine construct validity, differences in participation levels and environmental barriers/facilitators were examined between those with (n = 56) and without disabilities (n = 57) via t-test. Internal consistency was computed using Cronbach's alpha. To examine test-retest reliability, a sub-sample of 70 participants completed the Y-PEM a second time, 2-4 weeks apart. The Intraclass correlation coefficient (ICC) was calculated.

RESULTS

Descriptively, participants with disabilities had lower levels of frequency and involvement across all four settings: home, school/educational, community, workplace. Internal consistency were 0.71 and above (up to 0.82) across all scales with the exception of home (0.52) and workplace frequency (0.61). Test-retest reliability were 0.70 and above (up to 0.85) across all settings except for environmental supports at school (0.66) and workplace frequency (0.43). Y-PEM was perceived as a valuable tool with relatively low burden.

CONCLUSIONS

Initial psychometric properties are promising. Findings support Y-PEM's use as a feasible self-reported questionnaire for individuals aged 12-30 years old.